AMPATH: Living Proof that No One Has to Die from HIV

Abstract

Background and Objective

The HIV/AIDS epidemic in sub-Saharan Africa is decimating populations, deteriorating economies, deepening poverty, and destabilizing traditional social orders. The advent of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) made significant supplemental resources available to sub-Saharan national programs for the prevention and treatment of HIV/AIDS, but few programs have demonstrated the capacity to use these resources to increase rapidly in size. In this context, AMPATH, a collaboration of Indiana University School of Medicine, the Moi University School of Medicine, and the Moi Teaching and Referral Hospital in Eldoret, Kenya, is a stunning exception. This report summarizes findings from an assessment of AMPATH staff perceptions of how and why this has happened.

Participants and Approach

Semistructured, in-depth, individual interviews of 26 AMPATH workers were conducted and recorded. Field notes from these interviews were generated by independent reviewers and subjected to close-reading qualitative analysis for themes.

Results

The themes identified were as follows: creating effectively, connecting with others, making a difference, serving those in great need, providing comprehensive care to restore healthy lives, and growing as a person and a professional.

Conclusion

Inspired personnel are among the critical assets of an effective program. Among the reasons for success of this HIV/AIDS program are a set of work values and motivations that would be helpful in any setting, but perhaps nowhere more critical than in the grueling work of making a complex program work spectacularly well in the challenging setting of a resource-poor country. Sometimes, even in the face of long odds, the human spirit prevails.

Appendix

AMPATH Staff Interview Themes

“Creating effectively”

New challenges, new opportunities

Program innovation

Being flexible

Making something really work

Making “long shots” pay off, taking risks

Using the advantages of working between organizations instead of within them

Sharing credit for our achievements with others (e.g., the Ministry of Health)

Investing in training, education, counseling

Successful advocacy for patients and program

“Connecting with others”

Networking, liaising with community, including rural locations

Forming strong relationships to patients

Taking patients into our lives

Teamwork, trusting others, relying on others, partnering with other disciplines

Seeing other committed people work

The force of Joe Mamlin’s example, determination, confidence, success

Good, supportive working environment

“Making a difference”

Seeing people brought “back from the dead’

Growing a large program

Answering national-level questions

Being supported with what’s needed (various resources)

Responding to big needs

“Serving those in great need”

Believing in the potential of humankind

Serving the most needy, the most vulnerable

Treating children

Putting patients and their care first

“Providing comprehensive care to restore healthy lives”

Treating the whole person, being patient-centered

Working on prevention, behavior change

Fostering hope, recovery, independence

Providing psychosocial support, nutrition and income security

“Growing as a person and a professional”

Finding work

Being trusted with big responsibilities

Getting training, new skills

Having and using relevant expertise to the fullest

Experiencing pride of accomplishment

Being collaborative, truthful, totally committed, competent, confident, efficient

Becoming good at working with other people

Being in a good work environment, supportive and trustworthy

Being in a transformative community of care